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Healthcare 2020: Video, Vaping, Value and MoreFrom new tech, to better therapy, to resolution on vaping, what will dominate discussion in US medicine this decade?
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Laboratory monitoring for spironolactone in congestive heart failureWe evaluated how well patients taking spironolactone were monitored for hyperkalemia, as well as the association between spironolactone and hyperkalemia. Only two thirds of patients received testing for serum potassium and creatinine levels, and higher baseline serum creatinine levels predicted a high risk of hyperkalemia. These results indicate that appropriate patient selection and close monitoring are essential, especially for patients with renal impairment.
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After the Tsunami, Physician Volunteers Find Obstacles Both Obvious and UnexpectedEnoch Choi, MD, writes about his experiences leading a disaster relief team in Japan.
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Obesity and cardiovascular risk in hypertensive patients with left ventricular hypertrophyThe observed relationship linking obesity, severity of hypertension, and increase in cardiovascular risk was traditionally thought to emanate from the increase in circulatory volume, persistently increased systemic resistance from obesity, and clustering of major cardiovascular risk factors (eg, hypercholesterolemia and diabetes mellitus) among obese patients.
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Recognizing the Signs of PheochromocytomaPheochromocytoma is a rare chromaffin cell neoplasm that secretes catecholamines and is usually found in the adrenal medulla. One fourth of these tumors are the result of genetic inheritance. Hypertension is the most common symptom. The classic triad of paroxysmal symptoms?consisting of palpitations, diaphoresis, and headaches?should prompt a consideration of this diagnosis and appropriate laboratory testing. The best biochemical marker is plasma free metanephrines, which is 99% sensitive and 89% specific for diagnosis. Magnetic resonance imaging and radioactive iodine metaiodobenzylguanidine scans are used to localize the tumor before surgery.
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Implementing Price Transparency Tools at Ambulatory Care CentersPatients are satisfied with an online cost-estimator tool, according to findings of a recent study.
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Physicians' Investment Decisions Magnified Due to Earnings Potential UncertaintyMany physicians are feeling the earnings squeeze amidst the tectonic shifts in the health care system and changing US demographics.
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Swapping Soda for Coffee Can Reduce Stroke RiskPerhaps, a very simple change in beverage choice could reduce the stroke burden in the United States.
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Large-scale clinical epidemiology of stable angina in women and menWe performed a whole-country study using linked health care records in Finland and showed that stable angina as the initial symptomatic manifestation of coronary disease occurs as frequently in women as it does in men. Among easily recognized subgroups, the absolute rates of prognostic outcomes were similarly high in women and men.
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Psychiatric Medication as a Warm CoatI'd like to introduce Junig's Warm Coat Theory of Psychotropic Prescribing, or what I suggest the medical field refers to as the "JWCT."
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ARBs and the Impact of Worsening Renal Function in Heart Failure Patients With Preserved EFWorsening renal function over time is associated with poorer outcomes in patients with acute and chronic HF. Although this association is established in patients with reduced ejection fraction, there are no data about the relationship between WRF and outcomes in HF patients with preserved ejection fraction.
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Body mass index and cardiovascular events in patients with hypertension and left ventricular hypertrophyIn a separate analysis of patients enrolled in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study, thin patients and those with moderate-to-severe obesity were at increased risk for cardiovascular events. These results indicate that patients at the low anda high ends of the body size spectrum should be treated aggressively to lower the risk of cardiovascular events.
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Controversial Changes to Screening Recommendations for Preventive Pediatric CareThe American Academy of Pediatrics designed the 2014 Recommendations for Pediatrics Preventive Health Care to guide well-child care, but there is controversy over some of the changes.
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Lymph Nodes and Breast Cancer? Is Less as Good?How important is a completion node dissection for women with a positive sentinel node biopsy in breast cancer?
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Mortality of patients with diabetes mellitus and acute myocardial infarctionWe evaluated trends in the treatment and mortality of patients with and without diabetes mellitus and acute myocardial infarction over the last decade. Despite improvements in the provision of evidence-based care, patients with diabetes did not derive improvements in long-term survival.
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Clinical Trial Disparities: A Case for DiversityThe challenge of eliminating disparities in clinical trials is being addressed by the Eliminating Disparities in Clinical Trials (EDICT) project, which recognizes that broadening diversity in clinical trials will result in improved effectiveness and safety of future medicines, improved trial quality, and reduced discrepancies in health equity.
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A misleading ECGA 10-year-old girl was brought to her primary care provider by her mother because she complained of chest pain earlier that morning. She also reported abdominal pain and nausea.
